Diferencia entre revisiones de «Flexor tenosynovitis»
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==Evaluation== | ==Evaluation== | ||
[[File:FTS_Riscinti|thumbnail|Waterbath POCUS demonstrating fluid collection between tendon and bone<ref>http://www.thepocusatlas.com/musculoskeletal/</ref>]] | |||
===Workup=== | ===Workup=== | ||
*CBC | *CBC | ||
Revisión del 20:31 10 ene 2018
Background
- Surgical emergency - flexor sheaths are contiguous with deep spaces of the hand
- Usually associated with a penetrating trauma
Clinical Features
- Pain with passive extension (often the first sign seen)
- Percussion tenderness (tenderness over entire length of flexor tendon sheath)
- Uniform swelling (symmetric finger swelling along length of the tendon sheath)
- Flexion posture (flexed posture of involved digit at rest to minimize pain)
Differential Diagnosis
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Evaluation
File:FTS Riscinti
Waterbath POCUS demonstrating fluid collection between tendon and bone[1]
Workup
- CBC
- ESR
- Ultrasound
- Xray
Evaluation
- Generally a clinical diagnosis, based on history and physical exam
Management
- Emergent hand surgery consult in ED
- Antibiotics (start immediately if suspected)
- Vancomycin 1gm IV q12hr AND
- Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h
Disposition
- Admit
See Also
External Links
Video
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